ORAL STEROIDS

Drug Description:

Oxymetholone is a potent oral anabolic steroid derived from dihydrotestosterone. It is considered by some to be the most powerful steroid commercially available. A steroid novice experimenting with this agent is likely to gain 20 to 30 pounds of bulk, and it can often be accomplished within a few weeks of use, however this steroid produces a lot of water retention, so a good portion of this gain is going to be water weight rather than actual muscle tissue.

Therapeutic use:

Indicated uses included geriatric debilitation, chronic underweight states, pre-and postoperative preservation of lean mass, convalescence from infection, gastrointestinal disease, osteoporosis, and general catabolic conditions. The recommended dose for such uses was usually 2.5 mg three times per day. The drug was originally supplied in a 2.5 mg,5 mg, or 10 mg tablet.

More recently; the drug is used mainly to treat anaemia and muscle wasting in HIV patients. However it is rarely prescribed for such uses and as such is not usually seen in clinical setting in the UK. Other drugs with less side-effects have largely taken the place of oxymetholone. (MC)

How it is supplied:

Most often seen as a 50mg tablet. Can come in strips in a box, or in a small plastic container. (MC)

How it is used:

Usually used in doses between 50-100mg daily (1-2 tablets) for no more than 8 weeks; with at least 8 weeks break before recommencing use.

Side Effects/Risks:

Although oxymetholone is classified as an anabolic steroid, androgenic side effects are still possible with this substance. These may include bouts of oily skin, acne, body/facial hair growth. Higher doses are more likely cause such side effects. Anabolic/androgenic steroids may also aggravate male pattern hair loss. Women are additionally warned of the potential virilising effects of anabolic/androgenic steroids. These may include I deepening of the voice, menstrual irregularities, change in skin texture, facial hair growth, and clitoral enlargement. While Anadrol is classified as an anabolic steroid, it does retain a notable androgenic component. (The greater the androgenic quality, the greater the potential for side-effects)

Oxymetholone is a c17-alpha alkylated compound. This alteration protects the drug from deactivation by the liver, allowing a very high percentage of the drug entry into the bloodstream following oral administration. C17-alpha alkylated anabolic/androgenic steroids can be hepatotoxic (poisonous to the liver). Prolonged or high exposure may result in liver damage. In rare instances life-threatening dysfunction may develop. It is advisable to visit a physician periodically during each cycle to monitor liver function and overall health. Intake of c17-alpha alkylated steroids is commonly limited to 6-8 weeks, in an effort to avoid escalating liver strain.

Anabolic/androgenic steroids can have negative effects on serum cholesterol. This includes a tendency to reduce HDL (good) cholesterol values and increase LDL (bad) cholesterol values, which may shift the HDL to LDL balance in a direction that favours greater risk of arteriosclerosis. The relative impact of an anabolic/androgenic steroid on serum lipids is dependent on the dose, route of administration (oral vs. injectable), type of steroid (aromatisable or non- aromatisable), and level of resistance to hepatic metabolism. Anabolic/androgenic steroids may also adversely affect blood pressure and triglycerides, reduce endothelial relaxation, and support left ventricular hypertrophy, all potentially increasing the risk of cardiovascular disease and myocardial infarction. The use of oxymetholone should be undertaken only after careful consideration in people with high cholesterol or a familial history of heart disease.

Drug Description:

Dianabol is an oral anabolic steroid and the most recognized trade name for the drug methandrostenolone, also referred to as methandienone in many countries. Methandrostenolone is a derivative of testosterone, modified so that the hormone's androgenic (masculinizing) properties are reduced and its anabolic (tissue building) properties preserved. It is the most commonly used oral anabolic steroid for physique and performance enhancing purposes.

Therapeutic use:

There are no current medical uses for Methandrostenolone.

How it is supplied:

Methandrostenolone is widely available in both human and veterinary drug markets. Composition and dosage may vary by country and manufacturer. Methandrostenolone was designed as an oral anabolic steroid containing 2.5 mg or 5 mg of steroid per tablet (Dianabol). Modern brands usually contain 5 mg or 10 mg per tablet. Methandrostenolone can also be found in injectable veterinary preparations. These are typically oil-based solutions that carry 25 mg/ml of steroid.

How it is used:

The original prescribing guidelines for Dianabol called for a daily dosage of 5 mg. This was to be administered on an intermittent basis, with the drug taken for no more than 6 consecutive weeks. Thereafter, a break of 2 to 4 weeks was advised before therapy was resumed. For physique-or performance-enhancing purposes, the drug is also used intermittently, with cycles usually lasting between 6 and 8 weeks in length followed by 6-8 weeks off. Although a low dose of 5 mg daily may be effective for improving performance, athletes typically take much higher amounts. A daily dosage of three to six 5 mg tablets (15-30 mg) is most common, and typically produces very dramatic results. Some venture even higher in dosage, but this practice usually leads to a more profound incidence of side effects, and is generally discouraged.

Women & Young people:

Being moderately androgenic, Dianabol is really only a popular steroid with men. When used by women, strong virilisation symptoms are possible. Some do experiment with it, however, and often find low doses (2.5-5 mg) of this steroid quite effective for new muscle growth. Studies have demonstrated that a majority of women will notice acne, which is indicative of androgenicity, at a dosage of only 10 mg per day. Children are likely to notice virilising effects with as little as 2.5 mg per day.

Side Effects:

Methandrostenolone is aromatised by the body, and is a moderately oestrogenic steroid. Gynaecomastia is often a concern during treatment, and may present itself quite early into a cycle (particularly when higher doses are used). At the same time water retention can become a problem, causing a notable loss of muscle definition as both subcutaneous water retention and fat levels build.

Although classified as an anabolic steroid,androgenic side effects are still common with this substance. This may include bouts of oily skin, acne, and body/facial hair growth. Anabolic/androgenic steroids may also aggravate male pattern hair loss. Women are additionally warned of the potential virilizing effects of anabolic/androgenic steroids. These may include a deepening of the voice, menstrual irregularities, changes in skin texture, facial hair growth, and clitoral enlargement.

Methandrostenolone is a c17-alpha alkylated compound. This alteration protects the drug from deactivation by the, liver, allowing a very high percentage of the drug entry into the bloodstream following oral administration. C17! alpha alkylated anabolic steroids can be hepatotoxic. Prolonged or high exposure may result in liver damage. All anabolic/androgenic steroids when taken in doses sufficient to promote muscle gain are expected to suppress endogenous testosterone production. Methandrostenolone is no exception, and is noted for its strong influence on the hypothalamic-pituitary-testicular axis. Clinical studies giving 15 mg per day to resistance (weight) training males for 8 weeks caused the mean plasma testosterone level to fall by 69%. Without the intervention of testosterone-stimulating substances, testosterone levels should return to normal within 1-4 months of drug secession. Note that prolonged hypogonadotrophic hypogonadism can develop secondary to steroid abuse, necessitating medical intervention.

Drug Description:

Oxandrolone is an oral anabolic steroid derived from dihydrotestosterone. It was designed to have a very strong separation of anabolic and androgenic effect, and no significant estrogenic or progestational activity. Oxandrolone is noted for being quite mild as far as oral steroids are concerned, well-tailored for the promotion of strength and quality muscle tissue gains without significant side effects. Milligram for milligram it displays as much as six times the anabolic activity of testosterone in assays, with significantly less androgenicity.398 This drug is a favourite of dieting bodybuilders and competitive athletes in speed/anaerobic performance sports, where its tendency for pure tissue gain (without fat or water retention) fits well with the desired goals. However, it is also an expensive drug by comparison to other similar anabolic agents.

Therapeutic use:

In the United States, oxandrolone is the anabolic steroid most widely prescribed for the treatment of growth failure. It is usually given as a supportive medication, used to augment the anabolic effects of human growth hormone therapy. The drug is typically taken for periods of 6-12 months at a time, in an effort to accelerate the growth rate without substantially affecting the rate of I epiphysis fusion. A dosage of 2.5 mg per day is often used for this purpose, although this may be adjusted upwards or downwards depending on the patient's sex, age, bodyweight, and sensitivity to adverse effects. When used under optimal conditions, the result may be an enhancement of the growth rate and an increase in total height compared to not initiating therapy. This benefit has . been difficult to achieve consistently in clinical studies, however.

How it is supplied:

Oxandrolone is available in select human drug markets. Composition and dosage may vary by country and manufacturer. The original Anavar brand contained 2.5 mg of steroid per tablet. Oxandrin contains 2.5 mg or 10 mg per tablet. Other modern brands commonly contain 2.5 mg, 5 mg, or 10 mg of steroid per tablet.

How it is used:

The original prescribing guidelines for Anavar called for a daily dosage of between 2.5 mg and 20 mg per day (5-10 mg being most common). This was usually recommended for a period of two to four weeks, but occasionally it was taken for as long as three months. The dosing guidelines recommended with the current u.s. production form of the drug (Oxandrin, Savient Pharmaceuticals) also call for between 2.5 and 20 mg of drug per day, taken in intermittent cycles of 2 to 4 weeks. The usual dosage for physique-or performance-enhancing purposes is in the range of 15-25 mg per day, taken for 6 to 8 weeks. These protocols are not far removed from those of normal therapeutic situations.

For Women:

The original prescribing guidelines for Anavar did not offer separate dosing recommendations for women, although it was indicated that women who were pregnant, or may become pregnant, should not use the drug. The current guidelines for Oxandrin also do not make special dosing recommendations for women. Women who fear the masculinizing effects of many steroids would be quite comfortable using this drug, as these properties are very rarely seen with low doses. For physique-or performance-enhancing purposes, a daily dosage of 5-10 mg should illicit considerable growth without the noticeable androgenic side effects of other
drugs. This would be taken for no longer than 4-6 weeks.

Side Effects:

Oxandrolone is not aromatised by the body, and is not measurably oestrogenic. Oxandrolone also offers no related progestational activity. An anti-oestrogen is not necessary when using this steroid, as gynaecomastia should not be a concern even among sensitive individuals.
Although classified as an anabolic steroid, androgenic side effects are still common with this substance. This may include bouts of oily skin, acne, and body/facial hair growth. Anabolic/androgenic steroids may also aggravate male pattern hair loss. Women are additionally warned of the potential virilizing effects of anabolic/androgenic steroids. These may include a deepening of the voice, menstrual irregularities, changes in skin texture, facial hair growth, and clitoral enlargement.
Oxandrolone is a c17-alpha alkylated compound. This alteration protects the drug from deactivation by the, liver, allowing a very high percentage of the drug entry into the bloodstream following oral administration. C17 alpha alkylated anabolic steroids can be hepatotoxic. Prolonged or high exposure may result in liver damage.

All anabolic/androgenic steroids when taken in doses sufficient to promote muscle gain are expected to suppress endogenous testosterone production. Oxandrolone is no exception. In a study on HIV+ males, twelve weeks of 20 mg or 40 mg per day caused an approximate 40% reduction in serum testosterone levels. The group taking 80 mg noticed a 66% decrease in testosterone. Similar trends of decrease were noticed in LH production, with the 20 mg and 40 mg doses causing a 25-30% reduction, and the 80 mg group noticing a decline of more than 50%. Additionally, studies on boys with constitutionally delayed puberty have demonstrated significant suppression of endogenous LH and testosterone with as little as 2.5 mg per day. Without the intervention of testosterone stimulating substances, testosterone levels should return to normal within 1-4 months of drug secession. Note that prolonged hypogonadotrophic hypogonadism can develop secondary to steroid abuse, necessitating medical intervention.

Drug Description:

Winstrol is the most widely recognized trade name for the drug stanozolol. Stanozolol is a derivative of dihydrotestosterone, chemically altered so that the hormone's anabolic (tissue-building) properties are greatly amplified and its androgenic activity minimized. Stanozolol is classified as an "anabolic" steroid, and exhibits one of the strongest dissociations of anabolic to androgenic effect among commercially available agents. It also cannot be aromatized into oestrogens. Stanozolol is the second most widely used oral steroid, succeeded in popularity only by Dianabol (methandrostenolone).lt is favored for its ability to promote muscle growth without water-retention, making it highly valued by dieting bodybuilders and competitive athletes.

The injectable form is known as Stanozolol Depot and comes in the form of a water-based suspension. (MC)

Therapeutic use:

Stanozolol has been prescribed to treat anaemia, hereditary angioedema, urticaria, Raynaud's phenomenon, and, cryofibrinogenemia and lipodermatosclerosis. The primary use is in treating angioedema (swelling of the extremities, face, upper airways or genital area)

How it is supplied:

Stanozolol is widely available in both human and veterinary drug markets. Composition and dosage vary by country and manufacturer. Stanozolol was originally designed as an oral anabolic steroid, containing'i 2mg of drug per tablet (Winstrol). Other brands commonly contain 5 mg or 10 mg per tablet. Stanozolol can also be found in injectable preparations. These are commonly water-based suspensions carrying 50 mg/ml steroid.

How it is used:

The original prescribing guidelines for Winstrol called for daily dosage of 6mg, which was administered on schedule of one 2mg tablet three times per day. The usual dosage for physique-or performance-enhancing purposes is between 15 mg and 25 mg per day, or three five 5 mg tablets, taken for no longer than 6-8 weeks. Injectable Winstrol is generally recommended at a dosage of one 50 mg injection every 2-3 weeks. When used for physique-or performance-enhancing purposes dosage of 50 mg every other day is most commonly applied. Veterinary stanozolol preparations with a large particle size will be more slowly dispersed by the body and are commonly given at 75 mg every third day.

The original prescribing guidelines for Winstrol called for a daily dosage of 4mg (one 2mg tablet twice daily) with young women particularly susceptible to the androgenic effects of anabolic steroids. This dosage was increased to 6mg (the same as the recommended dose for males) when necessary. When used for physique-or performance-enhancing purposes, a dosage of 5 mg to 10 \g daily is most common, taken for no longer than 4-6 weeks. lnjectable Winstrol is generally recommended at a clinical dose of 50 mg every 2-3 weeks.

The injectable is usually not advised with women for physique-or performance-enhancing purposes, as it allows for less control over blood hormone levels. Those women who absolutely must use the injectable commonly administer 25 mg every 3 or 4 days. Although this compound is weakly androgenic, the risk of virilisation symptoms cannot be completely excluded, even at therapeutic doses.

Side Effects:

Although classified as an anabolic steroid, androgenic side effects are still common with this substance. This may include bouts of oily skin, acne, and body/facial hair growth. Anabolic/androgenic steroids may also aggravate male pattern hair loss. Women are additionally warned of the potential virilising effects of anabolic/androgenic steroids. These may include a deepening of the voice, menstrual irregularities, changes in skin texture, facial hair growth, and clitoral enlargement.

Stanozolol is a c17-alpha alkylated compound. This alteration protects the drug from deactivation by the, liver, allowing a very high percentage of the drug entry into the bloodstream following oral administration. C17 alpha alkylated anabolic steroids can be hepatotoxic. Prolonged or high exposure may result in liver damage.

Women are also warned of the potential virilising effects of anabolic/androgenic steroids. These II may include a deepening of the voice, menstrual irregularities, changes in skin texture, facial hair growth) and clitoral enlargement.

Anabolic/androgenic steroids can have deleterious effects on serum cholesterol. This includes a tendency to reduce HDL (good) cholesterol values and increase LDL (bad) cholesterol values, which may shift the HDL to LDL balance in a direction that favours greater risk of arteriosclerosis. The relative impact of an anabolic/androgenic steroid on serum lipids is dependent on the dose, route of administration (oral vs. injectable), type of steroid (aromatisable or non-aromatisable), and level of resistance to hepatic metabolism. Anabolic/androgenic steroids may also adversely affect blood pressure and triglycerides, reduce endothelial relaxation, and support left ventricular hypertrophy, all potentially increasing the risk of cardiovascular disease and myocardial infarction.

All anabolic/androgenic steroids when taken in doses sufficient to promote muscle gain are expected to suppress endogenous testosterone production. Stanozolol is no exception, and is noted for its strong influence on the hypothalamic-pituitary-testicular axis Clinical studies giving 10 mg per day to healthy male subjects for 14 days caused the mean plasma testosterone level to fall by 55%. Testosterone is the primary male androgen, and offers strong negative feedback on endogenous testosterone production. Testosterone-based drugs will likewise have a strong effect on the hypothalamic regulation of natural steroid hormones. Without the intervention of testosterone-stimulating substances, testosterone levels should return to normal within 1-4 months of drug secession. Note that prolonged hypogonadotrophic hypogonadism can develop secondary to steroid abuse, necessitating medical intervention.

Drug Description:

Proviron® is Schering's brand name for the oral androgen mesterolone (1-methyl dihydrotestosterone). Similar to dihydrotestosterone, mesterolone is a strong androgen with only a weak level of anabolic activity.This is due to the fact that like dihydrotestosterone, mesterolone is rapidly reduced to inactive diol metabolites in muscle tissue where concentrations of the 3-hydroxysteroid dehydrogenase enzyme are high. The belief that the weak anabolic nature of this compound indicates a tendency to block the androgen receptor in muscle tissue, thereby reducing the gains of other more potent muscle-building steroids, should likewise not be taken seriously. In fact, due to its extremely high affinity for plasma binding proteins such as SHBG, mesterolone may actually work to potentate the activity of other steroids by displacing a higher percentage into a free, unbound state.

Among athletes, mesterolone is primarily used to increase androgen levels when dieting or preparing for a contest, and as an anti-oestrogen due to its intrinsic ability to antagonize the aromatase enzyme.

Therapeutic use:

It is generally prescribed to males for the treatment of declining physical and mental capacity caused by age and subnormal androgen levels, low libido caused by insufficient androgen levels, hypogonadism (in pre-and post-pubescent males), and infertility (in certain situations mesterolone increases the quality and quantity of sperm).

How it is supplied:

Mesterolone is widely available in human drug markets. Composition and dosage may vary by country and manufacturer; preparations generally contain 25 mg or 50 mg of steroid per tablet.

How it is used:

To treat androgen insufficiency, mesterolone is usually given in a dose of 1 tablet (25 mg) three times per day at the initiation of therapy. The drug is later continued at a lower maintenance dose, which usually consists of taking 1 tablet (25 mg) one to two times per day. Similar doses are used to support male fertility, usually in conjunction with other fertility drugs like injectable FSH. The usual dosage among male athletes is between 50 mg and 150 mg of mesterolone per day, or two to six 25 mg tablets. The drug is typically taken in cycles of 6-12 weeks in length, which is usually a sufficient period of time to notice the benefits of drug therapy.

Mesterolone is not approved for use in women. This agent is not recommended for women for physique-or performance-enhancing purposes due to its strong androgenic nature and tendency to produce virilising side effects. Some women do favour the drug, however, and find a single 25 mg tablet enough to efficiently shift the hormone balance in the body, greatly impacting the look of definition to the physique. Intake is usually limited to no longer than four or five weeks in such situations to minimize the chance of developing lasting virilising effects.

Side Effects:

Mesterolone is not aromatised by the body, and is not measurably oestrogenic. An anti-oestrogen is not necessary when using this steroid, as the drug is unlikely to induce gynaecomastia, water retention, or other oestrogen-related side effects. Mesterolone is actually believed to act as an anti-aromatase in the body, preventing or slowing the conversion of steroids into oestrogen.

Mesterolone is classified as an androgenic steroid. Androgenic side effects are common with this substance, especially with higher doses. This may include ·bouts of oily skin, acne, and body/facial hair growth. Anabolic/androgenic steroids may also aggravate male pattern hair loss.

Women are also warned of the potential virilising effects of anabolic/androgenic steroids. These may include a deepening of the voice, menstrual irregularities, changes in skin texture, facial hair growth, and clitoral enlargement.

Additionally, the 5-alpha reductase enzyme does not metabolize mesterolone, so its relative androgenicity is not affected by finasteride or dutasteride.

Mesterolone is not c17-alpha alkylated, and not known to produce hepatotoxic effects; liver toxicity is unlikely.

Anabolic/androgenic steroids can have deleterious effects on serum cholesterol. This includes a tendency to reduce HDL (good) cholesterol values and increase LDL (bad) cholesterol values, which may shift the HDL to LDL balance in a direction that favors greater risk of arteriosclerosis. The relative impact of an anabolic/androgenic steroid on serum lipids is dependent on the dose, route of administration (oral vs. injectable), type of steroid (aromatizable or non-aromatizable), and level of resistance to hepatic metabolism. Mesterolone is an oral non-aromatizable androgen,and expected to have a notable negative effect on lipids. Studies administering 100 mg of mesterolone per day to hypogonadal men for approximately 6 months demonstrated a significant increase in total cholesterol (18.8%) and LDL cholesterol (65.2%), accompanied by a significant decrease in HDL cholesterol (-35.7%). Mesterolone should not be used when cardiovascular risk factors preclude the use of other oral steroids.

INJECTABLE STEROIDS

Drug Description:

Nandrolone decanoate is an injectable form of the anabolic steroid nandrolone. The decanoate ester provides a slow release of nandrolone from the site of injection, lasting for up to three weeks. Nandrolone is very similar to testosterone in structure, although it lacks a carbon atom at the 19th position (hence its other name, 19-nortestosterone). Like testosterone, nandrolone exhibits relatively strong anabolic properties. Unlike testosterone, however, its tissue-building activity is accompanied by weak androgenic properties. Much of this has to do with the reduction of nandrolone to a weaker steroid, dihydronandrolone, in the same androgen-responsive target tissues that potentate the action of testosterone (by converting it to DHT). The mild properties of nandrolone decanoate have made it one of the most popular injectable steroids worldwide, highly favoured by athletes for its ability to promote significant strength and lean muscle mass gains without strong androgenic or oestrogenic side effects.

Therapeutic use:

Modern (approved) medical applications for the drug are even more refined than they were in the mid-1970's. In the United States, the drug is now only FDA approved for treating anaemia, although it is often also used "off label" to preserve lean mass in HIV positive patients and others suffering from wasting diseases. Outside of the U.S., Organon seems to support the use of this drug mainly with patients suffering from severe anaemia, osteoporosis, and advanced breast cancer.

How it is supplied:

Nandrolone decanoate is widely available in human and veterinary drug markets. Composition and dosage may vary by country and manufacturer, but usually contain 25 II mg/ml, 50 mg/ml, 100 mg/ml, or 200 mg/ml of steroid dissolved in oil.

How it is used:

For general anabolic effects, early prescribing guidelines recommend a dosage of 50-100 mg every 3-4 weeks for 12 weeks. To treat renal anaemia, the prescribing guidelines for nandrolone decanoate recommend a dosage of 100-200 mg per week. The usual dosage for physique-or performance-enhancing purposes is the range of 200-600 mg per week, taken in cycles 8 to 12 weeks in length. This level is sufficient for most users to notice measurable gains in lean muscle mass and strength. It is often stated that nandrolone decanoate will exhibit its optimal effect (best gain/side effect ratio) at 2mg per pound of bodyweight/weekly, although individual differences in response will likely dictate varying ideal doses for different users. Deca is not known as a very "fast" builder. The muscle-building effect of this drug is quite noticeable but not dramatic. In general, one can expect to gain muscle weight at about half the rate of that with an equivalent amount of testosterone.

For women:

For general anabolic effects, early prescribing guidelines recommend a dosage of 50-100 mg every 3-4 weeks for 12 weeks. To treat renal anaemia, the prescribing guidelines for nandrolone decanoate recommend a dosage of 50-100 mg per week. When used for physique-or performance-enhancing purposes, a dosage of 50 mg per week is most common, taken for 4-6 weeks. Although only slightly androgenic, women are occasionally confronted with virilisation symptoms when taking this compound. Studies have demonstrated high tolerability (minor but statistically insignificant incidence of virilising side effects) with a dose of 100 mg every other week for 12 weeks,448 while long-term studies (+12 months of use) have demonstrated virilising side effects on a dose as low as 50 mg every 2-3 weeks. Should virilising side effects become a concern, nandrolone decanoate should be discontinued immediately to help prevent their permanent appearance. After a sufficient period of withdrawal, the shorter-acting nandrolone Durabolin® might be considered a safer option. This drug stays active for only several days, greatly reducing the withdrawal time if indicated.

Side Effects:

Although classified as an anabolic steroid, androgenic side effects are still possible with this substance, especially with higher doses. This may include bouts of oily skin, acne, and body/facial hair growth. Anabolic/androgenic steroids may also aggravate male pattern hair loss. Women are warned of the potential virilising effects of anabolic/androgenic steroids. These may include a deepening of the voice, menstrual irregularities, changes in skin texture, facial hair growth, and clitoral enlargement. Nandrolone is a steroid with relatively low androgenic activity relative to its tissue-building actions, making the threshold for strong androgenic side effects comparably higher than with more androgenic agents such as testosterone, methandrostenolone, or fluoxymesterone. lt is also important to point out that due to its mild androgenic nature and ability to suppress endogenous testosterone, nandrolone is prone to interfering with libido in males when used without another androgen.

Nandrolone is not c-17 alpha alkylated, and not known to have hepatotoxic effects in healthy subjects. Liver toxicity is unlikely.

Anabolic/androgenic steroids can have deleterious effects on serum cholesterol. This includes a tendency to reduce HDL (good) cholesterol values and increase LDL (bad) cholesterol values, which may shift the HDL to LDL balance in a direction that favors greater risk of arteriosclerosis. The relative impact of an anabolic/androgenic steroid on serum lipids is dependent on the dose, route of administration (oral vs. injectable), type of steroid (aromatizable or non-aromatizable), and level of resistance to hepatic metabolism. Studies administering 600 mg of nandrolone decanoate per week for 10 weeks demonstrated a 26% reduction in HDL cholesterol levels. This suppression is slightly greater than that reported with an equal dose of testosterone enanthate, and is in agreement with earlier studies showing a slightly stronger negative impact on HDL/LDL ratio with nandrolone decanoate as compared to testosterone cypionate. Nandrolone decanoate should still have a significantly weaker impact on serum lipids than c-17 alpha alkylated agents. Anabolic/androgenic steroids may also adversely affect blood pressure and triglycerides, reduce endothelial relaxation, and support left ventricular hypertrophy, all potentially increasing the risk of cardiovascular disease and myocardial infarction.

Drug Description:

Both Testosterone Cypionate and Testosterone Enanthate are long estered, or slow-acting forms of injectable testosterone. (MC)
According to William Llewellyn in Anabolics 2009; “Testosterone cypionate and testosterone enanthate provide extremely comparable patterns of testosterone reIease. Not only are physical advantages not possible in one over the other, but actual differences in pharmacokinetic patterns are hard to notice (these two drugs are for all intents and purposes functionally interchangeable).The only key difference between the two seems to be in the area of patient comfort. Cypionic acid is less irritating at the site of injection than enanthoic acid (enanthate) for a small percentage of patients. This makes testosterone cypionate a more favorable choice for those with recurring issues of injection-site pain with testosterone enanthate. This difference likely had something to do with the early development of this testosterone ester as a commercial drug product.”

The rest of this article will focus on Testosterone Cypionate but the details can also be applied to Testosterone Enanthate.

Therapeutic use:

The main use of testosterone cypionate in clinical medicine has historically been the treatment of low androgen levels in males, although many other applications have existed for this drug as well. During the 1960's, for example, the drug's prescribing recommendations called for such uses as supporting bone structure maturity, treating menorrhagia (heavy menstrual bleeding) and excessive lactation in females, and increasing muscle mass and combating osteoporosis in the elderly.

The primary use for either drug in the UK is hormone replacement therapy in males, although there are now non-injectable treatments that are more commonly used. (MC)

How it is supplied:

Testosterone cypionate is available in select human and veterinary drug markets. Composition and dosage may vary by country and manufacturer, but usually contain 50 mg/ml, 100 mg/ml, 125 mg/ml, or 200 mg/ml of steroid dissolved in oil.

The same applies to Testosterone Enanthate (MC)

How it is used:

To treat androgen insufficiency, the prescribing guidelines for testosterone cypionate call for a dosage of 50-400 mg every two to four weeks. Although active in the body for a longer time, testosterone cypionate is usually injected on a weekly basis for physique-or performance-enhancing purposes. The usual dosage is in the range of 200-600 mg per week, taken in cycles of 6 to 12 weeks in length. This level is sufficient for most users to notice exceptional gains in muscle size and strength.

While large doses are generally not advised, some bodybuilders have been known to use excessively high dosages of this drug (1,000 mg per week or more). This was much more common before the 1990's, when cypionate vials were usually very cheap and easy to find. At dosages of 800-1000 mg per week or more water retention will likely account for more of the additional weight gain than new muscle tissue. The practice of "megadosing" is inefficient (not to mention potentially dangerous), especially when we take into account the typical high cost of steroids today.

Testosterone is usually incorporated into bulking phases of training, when added water retention will be of little consequence, the user more concerned with raw mass than definition. Some do incorporate the drug into cutting cycles as well, but typically in lower doses (100-200 mg per week) and/or when accompanied by an aromatase inhibitor to keep oestrogen levels under control.

For Women

Testosterone cypionate is rarely used with women in clinical medicine. When applied, it is most often used as a secondary medication during inoperable breast cancer when other therapies have failed to produce a desirable effect and suppression of ovarian function is necessary. Testosterone cypionate is not recommended for women for physique-or performance-enhancing purposes due to its strong androgenic nature, tendency to produce virilising side effects, and slow-acting characteristics (making blood levels difficult to control).

Side Effects:

Testosterone is readily aromatised in the body to oestradiol (oestrogen). The aromatase (oestrogen synthetase) enzyme is responsible for this metabolism of testosterone. Elevated oestrogen levels can cause side effects such increased water retention, body fat gain, and gynaecomastia. Testosterone is considered a moderate oestrogenic steroid. An anti-oestrogen such as clomiphene citrate or tamoxifen citrate may be necessary to prevent oestrogenic side effects. One may alternately use aromatase inhibitors like Arimidex® (anastrozole), which more efficiently controls oestrogen by preventing synthesis. Aromatase inhibitors can be quite expensive comparison to anti-estrogens, however, and may also have negative effects on blood lipids.

Oestrogenic side effects will occur in a dose-dependent manner, with higher doses (above normal therapeutic levels) of testosterone cypionate more likely to require concurrent use of an anti-oestrogen or aromatase inhibitor. Since water retention and loss of muscle definition common with higher doses of testosterone cypionate, this drug is usually considered a poor choice for dieting cutting phases of training.

Women are warned of the potent virilising effects of anabolic/androgenic steroids, especially with a strong androgen such as testosterone. These may include deepening of the voice, menstrual irregularities, changes in skin texture, facial hair growth and clitoral enlargement.
Anabolic/androgenic steroids can have deleterious effects on serum cholesterol. This includes a tendency to reduce HDL (good) cholesterol values and increase LDL (bad) cholesterol values, which may shift the HDL to LDL balance in a direction that favours greater risk of arteriosclerosis. The relative impact of an anabolic/androgenic steroid on serum lipids is dependent on the dose, route of administration (oral vs. injectable), type of steroid (aromatisable or non-aromatisable), and level of resistance to hepatic metabolism. Anabolic/androgenic steroids may also adversely affect blood pressure and triglycerides, reduce endothelial relaxation, and support left ventricular hypertrophy, all potentially increasing the risk of cardiovascular disease and myocardial infarction.

Drug Description:

Testosterone propionate is a commonly manufactured injectable form of the primary male androgentestosterone. The added propionate ester will slow the rate in which testosterone is released from the injection site, but only for a few days. Testosterone propionate is, therefore, comparatively much faster-acting than other testosterone esters such as cypionate or enanthate, and requires a much more frequent dosing schedule. By most accounts testosterone propionate is an older and cruder form of injectable testosterone, made obsolete by the slower-acting and more comfortable esters that were developed subsequent to it. Still, those who are not bothered by the frequent injection schedule find testosterone propionate every bit as acceptable.

Therapeutic use:

Early prescribing guidelines for testosterone propionate called for a number of therapeutic uses. It was mainly applied to cases of male androgen insufficiency, and those issues normally surrounding low testosterone levels such as reduced sex drive and impotence in adults, and cryptorchidism (undescended testicles) in teenagers and young adults. But it also had such other uses as treating menopause, menorrhagia (heavy menstrual bleeding), menstrual tension, chronic cystic mastitis (fibrocystic breasts), endometriosis, and excessive lactation, covering a wide range of situations in which the male hormone testosterone was being applied to female patients. Over the years these wide guidelines were narrowed by the U.S. Food & Drug Administration, however, and by the 1980's, testosterone propionate was being largely applied only to male patients.

There are no current clinical uses for Testosterone Propionate in the UK (MC)

How it is supplied:

Testosterone propionate is widely available in human and veterinary drug markets. Composition and dosage may vary by country and manufacturer, but usually contain 25 mg/ml, 50 mg/ml, or 100 mg/ml of steroid dissolved in oil.

How it is used:

To treat androgen insufficiency, early prescribing guidelines recommended a dosage of 25 mg given two to three times per week. Modern product literature usually recommends 25 mg to 50 mg given two to three times per week for the same purpose. The usual dosage among male athletes is in the range of 50-100 mg per injection, which is given every second or third day. Similar to other esters of testosterone, testosterone propionate is commonly used at a weekly cumulative dosage between 200 mg to 400 mg. This level is sufficient for most users to notice exceptional gains in muscle size and strength.

For Women:

Testosterone propionate is rarely used with women in clinical medicine. When applied, it is most often used as a secondary medication during inoperable breast cancer, when other therapies have failed to produce a desirable effect and suppression of ovarian function is necessary. Testosterone propionate is not recommended for women for performance-enhancing purposes due to its strong androgenic nature and tendency to produce virilising side effects. Female bodybuilders who insist on using testosterone, however, often choose propionate, as blood levels are easier to control with this ester compared to cypionate or enanthate. Should virilisation symptoms develop, hormone levels will decline in a matter of days, instead of weeks, following drug cessation. The administration schedule is often more conservative as well, with a small injection (25 mg at most) given every 5 to 7 days, and cycle duration limited to 6-8 weeks or less.

Side Effects:

Testosterone is readily aromatised in the body to oestradiol (oestrogen). The aromatase (oestrogen synthetase) enzyme is responsible for this metabolism of testosterone. Elevated oestrogen levels can cause side effects such as increased water retention, body fat gain, and gynaecomastia. Testosterone is considered a moderately oestrogenic steroid. An anti-oestrogen such as clomiphene citrate or tamoxifen citrate may be necessary to prevent oestrogenic side effects. One may alternately use an aromatase inhibitor like Arimidex® (anastrozole), which more efficiently controls oestrogen by preventing its synthesis. Aromatase inhibitors can be quite expensive in comparison to anti-oestrogens, however, and may also have negative effects on blood lipids.
Estrogenic side effects will occur in a dose-dependent manner, with higher doses (above normal therapeutic levels) of testosterone propionate more likely to require the concurrent use of an anti-oestrogen or aromatase inhibitor. Since water retention and loss of muscle definition are common with higher doses of testosterone, this drug is usually considered a poor choice for dieting or cutting phases of training.

Women are warned of the potential virilising effects of anabolic/androgenic steroids, especially with a strong androgen such as testosterone. These may include deepening of the voice, menstrual irregularities, changes in skin texture, facial hair growth, and clitoral enlargement.

Anabolic/androgenic steroids can have deleterious effects on serum cholesterol. This includes a tendency to reduce HDL (good) cholesterol values and increase LDL (bad) cholesterol values, which may shift the HDL to LDL balance in a direction that favours greater risk of arteriosclerosis. The relative impact of an anabolic/androgenic steroid on serum lipids is dependent on the dose, route of administration (oral vs. injectable), type of steroid (aromatisable or non-aromatisable), and level of resistance to hepatic metabolism. Anabolic/androgenic steroids may also adversely affect blood pressure and triglycerides, reduce endothelial relaxation, and support left ventricular hypertrophy, all potentially increasing the risk of cardiovascular disease and myocardial infarction.
All anabolic/androgenic steroids when taken in doses sufficient to promote muscle gain are expected to suppress endogenous testosterone production. Testosterone is the primary male androgen, and offers strong negative feedback on endogenous testosterone production. Testosterone-based drugs will likewise have a strong effect on the hypothalamic regulation of natural steroid hormones. Without the intervention of testosterone-stimulating substances, testosterone levels should return to normal within 1-4 months of drug secession. Note that prolonged hypogonadotrophic hypogonadism can develop secondary to steroid abuse, necessitating medical intervention.

Drug Description:

Trenbolone acetate is an injectable (generally) anabolic steroid derived from nandrolone. Its activity is quite removed from its structural parent, however, such that direct comparisons between the two are difficult. Trenbolone is a non-oestrogenic steroid, and is considerably more anabolic and androgenic than nandrolone on a milligram for milligram basis. In appearance, it is much more commonly compared to a stronger androgen such as drostanolone, than it is to nandrolone. lt is also estimated to display about three times more androgenic potency than testosterone, making it one of the strongest injectable anabolic steroids ever commercially manufactured.

Therapeutic use:

There are no human therapeutic uses for this drug. It is used in farming in the form of an implant (Finaplex) for cattle to promote growth. There are no known legitimate human preparations available for this drug, in any form. (MC)

How it is supplied:

Trenbolone acetate is available in select veterinary drug markets. It generally comes in the form of implant pellets containing 20 mg of trenbolone acetate each. Injectable preparations containing 30 mg/ml of steroid in oil were formerly sold.

It is available as an injectable preparation from Underground Laboratories in a variety of dose strengths (MC) (See Sources of IPEDs)

How it is used:

Trenbolone acetate was never approved for use in humans. Prescribing guidelines are unavailable. An effective dosage for physique-or performance-enhancing purposes generally falls in the range of 100-300 mg per week, taken for 6 to 8 weeks. Due to the short-acting nature of acetateesters, the total week's dosage is subdivided into 2-3 smaller applications.

Side Effects:

Trenbolone is not aromatised by the body, and is not measurably oestrogenic. It is of note, however, that this steroid displays significant binding affinity for the progesterone receptor (slightly stronger than progesterone itself). The side effects associated with progesterone are similar to those of oestrogen, including negative feedback inhibition of testosterone production and enhanced rate of fat storage. Progestins also augment the stimulatory effect of oestrogens on mammary tissue growth. There appears to be a strong synergy between these two hormones here, such that gynaecomastia might even occur with the help of progestins, without excessive oestrogen levels. The use of an anti-oestrogen, which inhibits the estrogenic component of this disorder, is often sufficient to mitigate gynaecomastia caused by progestational anabolic/androgenic steroids. Note that progestational side effects are more common when trenbolone is being taken with other aromatisable steroids.

Although classified as an anabolic steroid, trenbolone is sufficiently androgenic. Androgenic side effects are still common with this substance, and may include bouts of oily skin, acne, and body/facial hair growth. Anabolic/androgenic steroids may also aggravate male pattern hair loss.

Women are also warned of the potential virilising effects of anabolic/androgenic steroids. These II may include a deepening of the voice, menstrual irregularities, changes in skin texture, facial hair growth) and clitoral enlargement.

Trenbolone is not c-17 alpha alkylated, and is generally not considered a hepatotoxic steroid; liver toxicity is unlikely. This steroid does have a strong level of resistance to hepatic breakdown, however, and severe liver toxicity has been noted in bodybuilders abusing trenbolone. Although unlikely, hepatotoxicity cannot be completely excluded, especially with high doses.

Anabolic/androgenic steroids can have deleterious effects on serum cholesterol. This includes a tendency to reduce HDL (good) cholesterol values and increase LDL (bad) cholesterol values, which may shift the HDL to LDL balance in a direction that favours greater risk of arteriosclerosis. The relative impact of an anabolic/androgenic steroid on serum lipids is dependent on the dose, route of administration (oral vs. injectable), type of steroid (aromatisable or non-aromatisable), and level of resistance to hepatic metabolism. Anabolic/androgenic steroids may also adversely affect blood pressure and triglycerides, reduce endothelial relaxation, and support left ventricular hypertrophy, all potentially increasing the risk of cardiovascular disease and myocardial infarction.
All anabolic/androgenic steroids when taken in doses sufficient to promote muscle gain are expected to suppress endogenous testosterone production. Testosterone is the primary male androgen, and offers strong negative feedback on endogenous testosterone production. Testosterone-based drugs will likewise have a strong effect on the hypothalamic regulation of natural steroid hormones. Without the intervention of testosterone-stimulating substances, testosterone levels should return to normal within 1-4 months of drug secession. Note that prolonged hypogonadotrophic hypogonadism can develop secondary to steroid abuse, necessitating medical intervention.

Drug Description:

Boldenone undecylenate is an injectable veterinary steroid that exhibits strong anabolic and moderately androgenic properties. The undecylenate ester extends the activity of the drug greatly (the undecylenate ester is only one carbon atom longer than decanoate), so that injections need to be repeated only once every 3 or 4 weeks.

Therapeutic use:

In the veterinary market, boldenone undecylenate is most commonly applied to horses, although in many regions it is indicated for use in other animals as well.

There are no known current therapeutic uses in humans for this drug. (MC)

How it is supplied:

Boldenone undecylenate is widely available in veterinary drug markets. Composition and dosage may vary by country and manufacturer; the majority of products are supplied as multi-dose glass vials containing an oily solution; usually carrying 25 mg/ml or 50 mg/ml of steroid.

It can be found in injectable preparations for humans with larger dose strengths, typically between 100-300mg/ml. (MC)

How it is used:

There are no approved uses for boldenone in humans, prescribing guidelines are not available (MC)

Although it stays active for a much longer timei boldenone undecylenate is injected at least weekly for physique-or performance-enhancing purposes. It is most commonly used at a dosage of 200-400 mg (4-8ml, 50 md version) per week. The dosage schedule can be divided to reduce the volume of each injection if necessary, perhaps administering the drug two to three times per week. One should also take caution to rotate injection sites regularly, so as to avoid irritation or infection.

Side Effects:

Boldenone is aromatised in the body to oestradiol (oestrogen). Elevated oestrogen levels can cause side effects such as increased water retention, body fat gain, and gynaecomastia. Boldenone is considered a mildly oestrogenic steroid. Aromatisation studies suggest that its rate of conversion to oestradiol is roughly half that of testosterone. The tendency to develop noticeable oestrogenic side effects with boldenone should be slightly higher than nandrolone, but much lower than with testosterone. Estrogenic side effects are usually not pronounced unless this drug is taken in doses above 200-400 mg per week. An anti-oestrogen such as clomiphene citrate or tamoxifen citrate might be used to help mitigate these side effects, should they become present. One may alternately use an aromatase inhibitor like Arimidex® (anastrozole), although it is considerably more expensive, and may negatively affect blood lipids.

Women are also warned of the potential virilising effects of anabolic/androgenic steroids. These II may include a deepening of the voice, menstrual irregularities, changes in skin texture, facial hair growth) and clitoral enlargement.

Anabolic/androgenic steroids can have deleterious effects on serum cholesterol. This includes a tendency to reduce HDL (good) cholesterol values and increase LDL (bad) cholesterol values, which may shift the HDL to LDL balance in a direction that favours greater risk of arteriosclerosis. The relative impact of an anabolic/androgenic steroid on serum lipids is dependent on the dose, route of administration (oral vs. injectable), type of steroid (aromatisable or non-aromatisable), and level of resistance to hepatic metabolism. Anabolic/androgenic steroids may also adversely affect blood pressure and triglycerides, reduce endothelial relaxation, and support left ventricular hypertrophy, all potentially increasing the risk of cardiovascular disease and myocardial infarction.
All anabolic/androgenic steroids when taken in doses sufficient to promote muscle gain are expected to suppress endogenous testosterone production. Testosterone is the primary male androgen, and offers strong negative feedback on endogenous testosterone production. Testosterone-based drugs will likewise have a strong effect on the hypothalamic regulation of natural steroid hormones. Without the intervention of testosterone-stimulating substances, testosterone levels should return to normal within 1-4 months of drug secession. Note that prolonged hypogonadotrophic hypogonadism can develop secondary to steroid abuse, necessitating medical intervention.

Drug Description:

Winstrol is the most widely recognized trade name for the drug stanozolol. Stanozolol is a derivative of dihydrotestosterone, chemically altered so that the hormone's anabolic (tissue-building) properties are greatly amplified and its androgenic activity minimized. Stanozolol is classified as an "anabolic" steroid, and exhibits one of the strongest dissociations of anabolic to androgenic effect among commercially available agents. It also cannot be aromatized into estrogens. Stanozolol is the second most widely used oral steroid, succeeded in popularity only by Dianabol (methandrostenolone). lt is favoured for its ability to promote muscle growth without water-retention, making it highly valued by dieting bodybuilders and competitive athletes.
The injectable form is known as Stanozolol Depot and comes in the form of a water-based suspension. (MC)

Therapeutic use:

Stanozololl has been prescribed to treat anaemia, hereditary angioedema, urticaria, Raynaud's phenomenon, and, cryofibrinogenemia and lipodermatosclerosis. The primary use is in treating angioedema (swelling of the extremities, face, upper airways or genital area)

How it is supplied:

Stanozolol is widely available in both human and veterinary drug markets. Composition and dosage vary by country and manufacturer. Stanozolol was originally designed as an oral anabolic steroid, containing'i 2mg of drug per tablet (Winstrol). Other brands commonly contain 5 mg or 10 mg per tablet. Stanozolol can also be found in injectable preparations. These are commonly water-based suspensions carrying 50 mg/ml steroid.

How it is used:

The original prescribing guidelines for Winstrol called for daily dosage of 6mg, which was administered on schedule of one 2mg tablet three times per day. The usual dosage for physique-or performance-enhancing purposes is between 15 mg and 25 mg per day, or three five 5 mg tablets, taken for no longer than 6-8 weeks. I Injectable Winstrol is generally recommended at a dosage of one 50 mg injection every 2-3 weeks. When used for physique-or performance-enhancing purposes dosage of 50 mg every other day is most commonly applied. Veterinary stanozolol preparations with a large particle size will be more slowly dispersed by the body and are commonly given at 75 mg every third day.

The original prescribing guidelines for Winstrol called for a daily dosage of 4mg (one 2mg tablet twice daily) with young women particularly susceptible to the androgenic effects of anabolic steroids. This dosage was increased to 6mg (the same as the recommended dose for males) when necessary. When used for physique-or performance-enhancing purposes, a dosage of 5 mg to 10g daily is most common, taken for no longer than 4-6 weeks.

lnjectable Winstrol is generally recommended at a clinical dose of 50 mg every 2-3 weeks.

The injectable is usually not advised with women for physique-or performance-enhancing purposes, as it allows for less control over blood hormone levels. Those women who absolutely must use the injectable commonly administer 25 mg every 3 or 4 days. Although this compound is weakly androgenic, the risk of virilisation symptoms cannot be completely excluded, even at therapeutic doses.

Side Effects:

Although classified as an anabolic steroid, androgenic side effects are still common with this substance. This may include bouts of oily skin, acne, and body/facial hair growth. Anabolic/androgenic steroids may also aggravate male pattern hair loss. Women are additionally warned of the potential virilising effects of anabolic/androgenic steroids. These may include a deepening of the voice, menstrual irregularities, changes in skin texture, facial hair growth, and clitoral enlargement.

Stanozolol is a c17-alpha alkylated compound. This alteration protects the drug from deactivation by the, liver, allowing a very high percentage of the drug entry into the bloodstream following oral administration. C17 alpha alkylated anabolic steroids can be hepatotoxic. Prolonged or high exposure may result in liver damage.

All anabolic/androgenic steroids when taken in doses sufficient to promote muscle gain are expected to suppress endogenous testosterone production. Stanozolol is no exception, and is noted for its strong influence on the hypothalamic-pituitary-testicular axis Clinical studies giving 10 mg per day to healthy male subjects for 14 days caused the mean plasma testosterone level to fall by 55%.

Women are also warned of the potential virilising effects of anabolic/androgenic steroids. These II may include a deepening of the voice, menstrual irregularities, changes in skin texture, facial hair growth) and clitoral enlargement.

Anabolic/androgenic steroids can have deleterious effects on serum cholesterol. This includes a tendency to reduce HDL (good) cholesterol values and increase LDL (bad) cholesterol values, which may shift the HDL to LDL balance in a direction that favours greater risk of arteriosclerosis. The relative impact of an anabolic/androgenic steroid on serum lipids is dependent on the dose, route of administration (oral vs. injectable), type of steroid (aromatisable or non-aromatisable), and level of resistance to hepatic metabolism. Anabolic/androgenic steroids may also adversely affect blood pressure and triglycerides, reduce endothelial relaxation, and support left ventricular hypertrophy, all potentially increasing the risk of cardiovascular disease and myocardial infarction.
All anabolic/androgenic steroids when taken in doses sufficient to promote muscle gain are expected to suppress endogenous testosterone production. Testosterone is the primary male androgen, and offers strong negative feedback on endogenous testosterone production. Testosterone-based drugs will likewise have a strong effect on the hypothalamic regulation of natural steroid hormones. Without the intervention of testosterone-stimulating substances, testosterone levels should return to normal within 1-4 months of drug secession. Note that prolonged hypogonadotrophic hypogonadism can develop secondary to steroid abuse, necessitating medical intervention.

Drug Description:

Sustanon® 250 is an oil-based injectable testosterone blend that contains four different testosterone esters: testosterone propionate (30 mg); testosterone Phenylpropionate (60 mg); testosterone isocaproate (60 mg); and testosterone decanoate (100 mg). Sustanon® is designed to provide a fast yet extended release of testosterone, usually requiring injections once every 3 to 4 weeks in a clinical setting. This is an improvement from standard testosterones such as cypionate or enanthate, which provide a shorter duration of activity. As with all testosterone products, Sustanon® 250 is a very strong anabolic drug with pronounced androgenic activity. It is most commonly used in bulking cycles, providing exceptional gains in strength and muscle mass. A shorteracting version of Sustanon®, called Sustanon® 100, is also made in certain areas.

NB: There are a large variety of testosterone blends available, most commonly made by underground laboratories (See Sources of IPEDs). The label will usually list the drugs contained in the blend, with some indication of the purported dose strength. Such blends are designed with much the same thinking as Sustanon, where different esters are used to provide both a fast and a sustained release of the active ingredients. (MC)

It is important to note that all such blends are just a mixture of anabolic steroids, so the effects and side-effects of the particular blend depend on the substances used, but will be no different to taking those same substances separately. (MC)

Therapeutic use:

Sustanon® 250 first appeared on international drug markets during the early 1970's. It was developed by the international pharmaceutical giant Organon, also responsible for such steroids as Durabolin®, DecaDurabolin®, and Andriol®. Sustanon® 250 was designed to offer a therapeutic advantage over existing single esters of testosterone, which need to be injected more frequently (cited advantages in hormone stability are probably not valid).

The drug is used therapeutically in female-to-male gender reassignment (sex change) and hormone replacement therapy for men. The advantage for the patient lies in less frequent injections (typically once every 3-4 weeks). (MC)

How it is supplied:

Sustanon® 250 is widely available in human and (select) veterinary drug markets. Packaging volume may vary by country and manufacturer; the majority of products are supplied as 1 mL glass ampules containing an oily solution; sold by or under license from Organon.

It should be noted that this product is extremely popular and therefore is often counterfeited, so it is important for the user to be aware they may not be using a genuine pharmaceutical product. (MC)

How it is used:

To treat androgen insufficiency, the prescribing guidelines for Sustanon® 250 call for a dosage of 250 mg every 3 weeks. Although active in the body for a longer time, Sustanon® 250 is usually injected every 7 to 10 days for muscle-building purposes. This schedule will allow for the higher doses most commonly applied by athletes and more stable elevations in hormone level. The usual dosage among male athletes is in the range of 250-750 mg per injection, taken in cycles 6 to 12 weeks in length. This level is sufficient for most users to notice exceptional gains in muscle size and strength.

Side Effects:

Testosterone is readily aromatized in the body to oestradiol (oestrogen). The aromatase (oestrogen synthetase) enzyme is responsible for this metabolism of testosterone. Elevated oestrogen levels can cause side effects such as increased water retention, body fat gain, and gynaecomastia. Testosterone is considered a moderately oestrogenic steroid. An anti-oestrogen such as clomiphene citrate or tamoxifen citrate may be necessary to prevent estrogenic side effects. One may alternately use an aromatase inhibitor like Arimidex® (anastrozole), which more efficiently controls oestrogen by preventing its synthesis. Aromatase inhibitors can be quite expensive in comparison to anti-oestrogens, however, and may also have negative effects on blood lipids.
Oestrogenic side effects will occur in a dose-dependent manner, with higher doses (above normal therapeutic levels) of testosterone propionate more likely to require the concurrent use of an anti-oestrogen or aromatase inhibitor. Since water retention and loss of muscle definition are common with higher doses of testosterone, this drug is usually considered a poor choice for dieting or cutting phases of training.

Women are warned of the potential virilising effects of anabolic/androgenic steroids, especially with a strong androgen such as testosterone. These may include deepening of the voice, menstrual irregularities, changes in skin texture, facial hair growth, and clitoral enlargement.

Anabolic/androgenic steroids can have deleterious effects on serum cholesterol. This includes a tendency to reduce HDL (good) cholesterol values and increase LDL (bad) cholesterol values, which may shift the HDL to LDL balance in a direction that favours greater risk of arteriosclerosis. The relative impact of an anabolic/androgenic steroid on serum lipids is dependent on the dose, route of administration (oral vs. injectable), type of steroid (aromatisable or non-aromatisable), and level of resistance to hepatic metabolism. Anabolic/androgenic steroids may also adversely affect blood pressure and triglycerides, reduce endothelial relaxation, and support left ventricular hypertrophy, all potentially increasing the risk of cardiovascular disease and myocardial infarction.
All anabolic/androgenic steroids when taken in doses sufficient to promote muscle gain are expected to suppress endogenous testosterone production. Testosterone is the primary male androgen, and offers strong negative feedback on endogenous testosterone production. Testosterone-based drugs will likewise have a strong effect on the hypothalamic regulation of natural steroid hormones. Without the intervention of testosterone-stimulating substances, testosterone levels should return to normal within 1-4 months of drug secession. Note that prolonged hypogonadotrophic hypogonadism can develop secondary to steroid abuse, necessitating medical intervention.

PEPTIDES

Drug Description:

As its name suggests, human growth hormone is an important mediator of the human growth process. This hormone is produced endogenously by the anterior pituitary gland, and exists at especially high levels during childhood. Its growth-promoting effects are broad, and can be separated into three distinct areas: bone, skeletal muscle, and internal organs. It also supports protein, carbohydrate, lipid, and mineral metabolism, and can stimulate the growth of connective tissues. Although vital to early development, human growth hormone is produced throughout adulthood. Its levels and biological role decline with age, but continue to support metabolism, muscle tissue growth/maintenance, and the management (reduction) of adipose tissue throughout life. Somatropin specifically describes pharmaceutical human growth hormone that was synthesized with the use of recombinant DNA technology. Somatropin (rhGH) is biologically equivalent to human growth hormone (hGH) of pituitary origin.

It should be noted that this product is extremely popular and therefore is often counterfeited, so it is important for the user to be aware they may not be using a genuine pharmaceutical product. (MC)

Therapeutic use:

In a medical setting, somatropin is used to treat a number of distinct health conditions. It is most notably associated with pituitary deficient dwarfism, a disease where linear growth is hindered due to insufficient endogenous growth hormone production. The drug is often given to these patients throughout childhood, and while not fully corrective, it is capable of substantially increasing linear growth before it is halted in adolescence. Somatropin is also commonly used in cases of adult-onset growth hormone deficiency, commonly associated with pituitary cancer or its treatment. It may also be prescribed to otherwise healthy individuals who are aging. The intent here is to maintain youthful levels of growth hormone, and impart an anti-aging effect.While not medically supported; the use of somatropin for this purpose is common in North America, South America, and Europe. Additionally, somatropin is used to, combat muscle wasting associated with HIV infection or other diseases, and may be prescribed to treat several other conditions including Burns, Short Bowel Syndrome, and Prader-Willi syndrome.

How it is supplied:

Somatropin is most commonly supplied in multi-dose vials containing a white lyophilized powder that requires reconstitution with sterile or bacteriostatic water before use. Dosage may vary widely from 1mg to 24mg or more per vial. Somatropin is also available as a stable pre-mixed solution (Nutropin AQ) that is biologically equivalent to reconstituted somatropin.

How it is used:

Somatropin is designed for subcutaneous or intramuscular administration. One milligram of somatropin is equivalent to approximately 3 International Units (3 IU). When used to treat adult onset growth hormone deficiency, the drug is commonly applied at a dosage of .OOS/mg/kg per day to .01 mg/kg per day. This equates to roughly 1 IU to 3 IU per day for person of approximately 180-220 Ibs. A long-term maintenance dosage is established after reviewing the patient's IGF-1 levels and clinical response over time.

When used for physique-or performance-enhancing purposes, somatropin is usually administered at a dosage between 1 IU and 6 IU per day (2-4 IU being most common). The drug is commonly cycled in a similar manner to anabolic/androgenic steroids, with the length of intake generally being between 6 weeks and 24 weeks. The anabolic effects of this drug are less apparent than its lipolytic (fat loss) properties, and generally take longer periods of time and higher doses to manifest themselves.

Storage:

Do not freeze. Follow package insert for storage information. Refrigeration (20 to 8°C, 35° to 460 F) may be required before and after reconstitution.

Side Effects:

The most common adverse reactions to somatropin therapy are joint pain, headache, flu-like symptoms, peripheral oedema (water retention), and back pain. Less common adverse reactions include inflammation of mucous membranes in the nose (rhinitis), dizziness, upper respiratory infection, bronchitis, tingling or numbness on the skin, reduced sensitivity to touch, general oedema, nausea, sore bones, carpal tunnel syndrome, chest pain, \ depression, gynaecomastia, hypothyroidism, and insomnia. The abuse of somatropin may cause diabetes, acromegaly (a visible thickening of the bones, most notably the feet, forehead, hands, jaw, and elbows),and enlargement of the internal organs. Due to the growth promotion effects of human growth hormone, this drug should not be used by individuals with active or recurring cancer.

Somatropin may reduce sensitivity to insulin and raise blood sugar levels. This may occur in individuals without pre-existing diabetes or impaired glucose tolerance.
The subcutaneous administration of somatropin may cause redness, itching, or lumps at the site of injection. It may also cause a localized decrease of adipose tissue, which may be compounded by the repeated administration at the same site of injection.

Melanotan was first synthesized at the University of Arizona in the 1980s.

A clinical trial conducted on three males by the College of Medicine, Pharmacology Department, University of Arizona in Tucson, Arizona published in 1996 reported that, "Melanotan II has tanning activity in humans given only 5 low doses every other day by subcutaneous injection." The side effects reported were mild nausea and a "stretching and yawning complex" that correlated with spontaneous penile erections.
Further trials were conducted in 1998 and 2000 with the focus being more on the treatment of erectile
dysfunction.

Current use as a tanning agent:

Melanotan (Afamelanotide) is a photo-protective drug that increases melanin levels in the human skin to gain protection from ultraviolet radiation (UVR) and sunlight. The drug aims to treat people suffering from UV and light-related skin disorders. Since 2000, Australian company Clinuvel Pharmaceuticals has been developing and testing afamelanotide. They have a number of trials due to finish sometime in 2012.

There are two slightly different Melanotan peptides. Melanotan I (MT1) is a straight, full length peptide, whilst Melanotan II (MT2) is a shortened version. Both Melanotan and Melanotan II promote a tanning effect; however there seem to be more side effects reported by users of MT II, particularly the increased libido and spontaneous erections.
MT2 is usually cheaper to purchase than MT1 and may be the reason it is more commonly used.

How is it supplied:

The most common way for Melanotan to be supplied as a white lyophilised powder, in multi dose vials, which require dilution at home. The diluents should be sterile ‘water for injection’ or ‘bacteriostatic water’ (bacteriostatic if the solution is going to be kept for any longer than a few days) and the dissolved solution stored in a refrigerator.

Dosages for MT2 are reported to range between 0.3mg per day to 1mg per day but caution is required as individuals may respond differently and there is no way of knowing the exact strength of the product as it has been produced illicitly.

MT2 is stronger than MT1. This is because MT1 is a weaker stimulator of melanin in humans. As such, a higher dose of MT1 is reportedly taken to achieve similar results.

Most vials contain 10mg of undiluted product. Regardless of type, the dissolved solution would be administered by subcutaneous injection.

Powder for injecting

An intra-nasal solution has recently been developed for those who do not want to inject. Although for many people this method of administration may be more desirable, it is also far more expensive.

Nasal Spray

Melanotan has never been licensed for the purpose of facilitating tanning and the Medicines and Healthcare products Regulatory Agency (MHRA) have warned people not to use these products.

Regardless of this advice, its use in the UK is widespread and needle exchanges frequently see people who are injecting this drug. Most supplies are purchased on-line, from a traditional steroid dealer at the local gym, from a beauty therapist or tanning salon.
Under UK law it is illegal to ship or sell the hormones but it is not illegal as a customer to buy them.

How is it used:

There are 2 phases related to the use of Melanotan:

Phase 1 involves daily dosing (subcutaneous injections). This phase usually lasts for 10-14 days or until the desired colour is achieved.

Phase 2 involves once or twice a week injections to maintain the desired colour

Side effects:

Darkening of the skin

Increased sexual desire (both men and women)

Nausea

Facial flushing

Fatigue

Vomiting

Flu like symptoms

Dramatic change in the appearance of freckles and moles

Risks / Dangers / Potential Problems:

There are risks associated with injecting any drug, Melanotan is no different. If injecting equipment is shared a risk of transmitting blood borne viruses is introduced whilst injecting in an un-sterile manner can cause infections and complications.

Serious concerns exist over drug content, dose, contaminants and sterility of the product itself. As most are made in unlicensed labs quality control is questionable.

Drug Description:

Insulin is a peptidehormone produced by the pancreas (MC). The main biological role of insulin is to promote the intracellular use of utilisation and storage of amino acids, glucose, fatty acids, whilst simultaneously inhibiting the breakdown of glycogen, protein and fat. It is most notably identified with the control of blood sugar levels and insulin medications are typically prescribed to people with diabetes, a metabolic disorder characterised by hyperglycaemia (high blood sugar). While insulin targets many different organs in the body, this hormone is both anabolic and anti-catabolic to skeletal muscle tissue, a fact that explains the inclusion of pharmaceutical insulin in the realms of athletics and bodybuilding.

Therapeutic use:

The therapeutic use for insulin is the management of diabetes.

How it is supplied:

There are a variety of synthetic insulins available, with each possessing unique properties relating to speed of onset, peak and duration of activity, and concentration of dose. This therapeutic variety may allow physicians to tailor a treatment program for insulin-dependent diabetics that allows for the least amount of daily injections and the greatest level of patient comfort. It is important that one should be aware of the individual activity of any insulin drug before attempting its use. Due to the differences between preparations, it is also medically advised that extreme care be taken whenever a physician attempts to switch an insulin-dependent diabetic patient from one form of insulin medication to another.

Below is a list showing the distinctions between popular forms of biosynthetic insulin.

Short-acting Insulins:

Humalog® (Insulin Lispro): Humalog® is a short-acting analog of human insulin, specifically the Lys(B28) Pro(B29) analog of insulin created when the amino acids at positions 28 and 29 are reversed. It is considered equipotent to regular soluble insulin on a unit-to-unit basis, but with more rapid activity. The onset of drug action following subcutaneous administration is approximately 15 minutes, and its peak effect is reached in 30 to 90 minutes. It has a total duration of action between 3 and 5 hours.

Novolog® (Insulin Aspart): Novolog is a short-acting analog of human insulin created when the amino acid proline at position B28 is replaced with aspartic acid. The onset of drug action following subcutaneous administration is approximately 15 minutes,and its peak effect is reached in 1-3 hours. It has a total duration of action between 3 and 5 hours.

Many athletes believe that its short window of effect makes it an ideal insulin medication for physique-or performance-enhancing purposes, as most of its action can be concentrated in the post-training enhanced-nutrient uptake window.

Humulin®-R /lRegular" (insulin Inj): Identical to human insulin. Also sold as Humulin-S® (Soluble) in some markets, this product consists of zinc-insulin crystals dissolved in clear fluid. There is nothing added to slow the release of this product so it is generically referred to as soluble human insulin. This drug works rapidly and has a short duration of effect. The onset of drug action following subcutaneous administration is 20-30 minutes, and its peak effect is reached in 1-3 hours. It has a total duration of action between 5 and 8 hours. Together with Humalog, these two forms of insulin are the most popular (almost exclusive) choices among athletes and bodybuilders for physique- or performance-enhancement purposes

Intermediate- and Long-acting Insulins:

Humulin®-N, NPH (insulin isophane): A crystalline suspension of insulin with protamine and zinc to delay its release and extend its action. Insulin isophane is considered intermediate length insulin.The onset of drug action following subcutaneous administration is approximately 1-2 hours, and its peak effect is reached in 4-10 hours. It has a total duration of activity lasting more than 14 hours. This type of insulin is not commonly used for physique- or performance-enhancement purposes

Humulino-L, Lente (medium zinc suspension): A crystalline suspension of insulin with zinc to delay its release and extend its action. Humulin-L is considered an intermediate length insulin. The onset of drug action following subcutaneous administration is approximately 1-3 hours, and its peak effect is reached in 6-14 hours. It has a total duration of activity lasting more than 20 hours. This type of insulin is not commonly used for physique- or performance-enhancement purposes.

Humulin®-U, Ultralente (prolonged zinc suspension): A crystalline suspension of insulin with zinc to delay its release and extend its action. Humulin-U is considered a long-acting insulin. The onset of drug action following subcutaneous administration is approximately 6 hours, and its peak effect is reached in 14-18 hours. It has a total duration of activity lasting 18-24 hours. This type of insulin is not commonly used for physique- or performance- enhancement purposes.

NB: It is important to note here, that there are a number of different preparations of insulin and each one has a different profile. The time to onset of drug action, the time to peak effect and the total duration of activity can all significantly affect the outcome of using them. This is an extremely powerful drug, highly variable in its action and its use must be approached with caution. (MC)

Warning: Concentrated Insulin

The most common forms of insulin come in a concentration of 100 IU of hormone per milliliter. These are identified as"U-100" preparations in the U.S. and many other regions. In addition to this, however, there are also concentrated forms of insulin available for patients that require higher doses and a more economical or comfortable option to U-100 preparations. In the U.S., products containing as much as 5 times the normal concentration, or 500 IU per milliliter, are also sold. These are identified as"U-500" preparations, and are available by prescription only.It can be extremely dangerous or life threatening to replace a U-100 insulin product with a U­500 product without making the necessary dosing adjustments to compensate for the greater drug concentration. Given the general difficulty in accurately measuring athletic doses (2-15 IU) with a drug of such high concentration, U-100 preparations are used almost exclusively for physique- and performance-enhancing purposes.

How it is used:

Given that there are varying forms of insulin available for medical use with differing pharmacokinetic patterns, as well as products with different drug concentrations, it is extremely important that the user be familiar with the dosage and actions of any specific insulin preparation they intend to use so that peak-effect, total time of effect, total dosage and carbohydrate intake can be closely monitored.

It is also important to stress that before one considers using insulin they should also become familiar with using a glucometer. This is a medical device that can give you a quick and accurate reading of your blood glucose levels.

Administration (Short-acting Insulin):

Short acting forms of insulin (Novolog, Humalog, Humulin-R) are designed for subcutaneous injection. Following subcutaneous injection, the injection site should be left alone and not rubbed, to prevent the drug from releasing into circulation too quickly. It is also advised to rotate subcutaneous injection sites regularly to avoid the localized buildup of subcutaneous fat that may develop due to the lipogenic properties of this hormone (see Adverse Reactions: Lipodystrophy). The medical dosage will vary depending on the individual requirements of the patient. Furthermore, changes in such things as diet, activity level, or work/sleep schedule may affect the required insulin dose. Although not recommended medically, it is possible to administer some short-acting insulins via intramuscular injection. This, however, may create more variability (and potential risk) with regard to drug dissipation and hypoglycemic effect.

Insulin dosages can vary slightly among athletes, and are often dependent upon factors like body weight, insulin sensitivity, activity level, diet, and the use of other drugs. Most users choose to administer insulin immediately after a workout, which is the most opportunistic time of the day to use this drug. Among bodybuilders, dosages of regular insulin (Humulin-R) used are usually in the range of 11U per 15-20 pounds of lean bodyweight; 10IU is perhaps the most common dosage. This amount may be adjusted downward slightly for users of the more rapid-acting Humalog and Novolog preparations, which provide a higher and faster peak effect. First-time cautious users usually ignore bodyweight guidelines, and instead start at a low dosage with the intention of gradually working up to a normal dosage. For example, on the first day of insulin therapy one may begin with a dose as low as 2 IU. Each consecutive post-workout application this dosage might be increased by 11U, until the user determines a comfortable range. Many feel this is safer and much more tailored to the individual than simply calculating and injecting a dose, as some find they tolerate slightly more or less insulin than weight guidelines would dictate. Athletes using growth hormone in particular often have slightly higher insulin requirements, as HGH therapy is shown to both lower secretion of, and induce cellular resistance to, insulin.

One must also remember that it is very important to consume carbohydrates for several hours following insulin use. One should generally follow the rule-of-thumb of ingesting at least 10-15 grams of simple carbohydrates per IU of insulin injected (with a minimum immediate intake of 100 grams regardless of dose).This is timed 10 to 30 minutes after subcutaneous injection of Humulin-R, or immediately after using Novolog or Humalog.The use of a carbohydrate replacement drink is often used as a fast carbohydrate source. Properly cautious insulin users will always have a source for simple sugars on-hand in case an unexpected drop in glucose levels is noticed. Many athletes will also take creatine monohydrate with their carbohydrate drink, since the insulin may help force more creatine into the muscles. 30-60 minutes after injecting insulin, one should also eat a good meal and consume a protein shake.

The carbohydrate drink and meal/protein shake are absolutely necessary, as without them blood sugar levels may drop dangerously low and the athlete may enter a state of hypoglycemia.Carbohydrates and proteins are continually provided in sufficient amounts to meet glucose requirements throughout the entire window of insulin effect.

Intermediate-acting, long-acting, and biphasic insulins are designed for subcutaneous injection. Intramuscular injection will cause the drug to be released too rapidly, potentially resulting in hypoglycaemia. Following subcutaneous injection, the injection site should be left alone and not rubbed, to prevent the drug from releasing into circulation too quickly. It is also advised to rotate subcutaneous injection sites regularly to avoid the localized buildup of subcutaneous fat due to the lipogenic properties of this hormone.

The medical dosage will vary depending on the individual requirements of the patient. Furthermore, changes in such things as diet, activity level, or work/sleep schedule may affect the required insulin dose. Intermediate-acting, long-acting, and biphasic insulins are not widely used for physique- or performance-enhancing purposes due to their longer acting nature, which makes them poorly suited for concentrating the nutrient partitioning effect of insulin during the short post-workout enhanced-nutrient-uptake window.

Side Effects:

Hypoglycaemia is the primary danger with the use of insulin. This is a dangerous condition that occurs when blood glucose levels fall too low. It is a common and potentially fatal reaction experienced at some time or another by most medical and nonmedical insulin users, so it needs to be taken seriously. It is, therefore, critical to understand the warning signs of hypoglycemia.

The following is a list of symptoms that may indicate mild to moderate hypoglycemia: hunger, drowsiness, blurred vision, depressive mood, dizziness, sweating, palpitation, tremor, restlessness, tingling in the hands, feet, lips, or tongue, lightheadedness, inability to concentrate, headache, sleep disturbances, anxiety, slurred speech, irritability, abnormal behavior, unsteady movement, and personality changes. If any of these warning signs should occur, one should immediately consume a food or drink containing simple sugars such as a candy bar or carbohydrate drink. This will hopefully raise blood glucose levels sufficiently enough to ward off mild to moderate hypoglycemia. There is always a possibility of severe hypoglycemia, which is very serious and requires immediate emergency medical attention. Symptoms of this include disorientation, seizure, unconsciousness, and death. Note that in some cases the symptoms of hypoglycemia are mistaken for drunkenness.

It is also very important to note that you may notice a tendency to get sleepy after injecting insulin. This is an early symptom of hypoglycemia, and a clear sign the user should be consuming more carbohydrates. One should absolutely avoid the temptation to go to sleep at this point, as the insulin may take its peak effect during rest, and blood glucose levels could be left to drop significantly. Unaware of this condition during sleep, the athlete may be at a high risk for going into a state of severe hypoglycemia. The serious dangers of such a state have already been discussed, and unfortunately consuming more carbohydrates during sleep will not be an option.

Those experimenting with insulin would, therefore, be wise to always stay awake for the duration of the drug's effect, and also avoid using insulin in the early evening to ensure the drug will not be inadvertently active when retiring for the night.

It is also important to make sure others are aware of your use of the drug so that they may inform emergency medical technicians should you lose consciousness or the ability to inform others of your condition due to hypoglycemia. This information can spare valuable (perhaps life saving) time in helping medical professionals establish a diagnosis and provide supportive treatment.

Drug Description:

Human Chorionic Gonadotropin (hCG) is a prescription medication containing chorionic gonadotropin obtained from a natural (human) origin. Chorionic gonadotropin is a polypeptide hormone normally found in the female body during the early months of pregnancy. It is synthesized in … the placenta, and is responsible for increasing the production of progesterone, a pregnancy-sustaining hormone. Chorionic gonadotropin is present in significant amounts only during pregnancy, and is used as an indicator of pregnancy by standard over the-counter pregnancy test kits.

Therapeutic use:

As a clinical drug, hCG is used as an exogenous form of LH .lt is typically applied to support ovulation and pregnancy in women, most specifically those suffering from infertility due to low concentrations of gonadotropins and an inability to ovulate. Due to the ability of LH to stimulate the Leydig's cells in the testes to manufacture testosterone, hCG is also used with men to treat hypogonadotropic hypogonadism, a disorder characterized by low testosterone levels and insufficient LH output. The drug is also used in the treatment of prepubertal cryptochidism, a condition in which one or both of the testicles have failed to descend into the scrotum.

HCG has no significant thyroid-stimulating activity, and is not an effective fat loss agent. This is specifically pointed out because hCG was once widely used for the treatment of obesity. The trend seemed to have become popular in 1954, after a paper was published by Dr. A.T.W. Simeons claiming that chorionic gonadotropin was an effective adjunct to dieting. According to the study, patients were able to effectively stave off hunger with severely low calorie diets provided they took the hormone injections. Dubbed the Simeons diet, people everywhere were soon subjecting themselves to severe calorie restriction (500 calories per day) and taking hCG injections. Soon after, the hormone itself became the main focus for fat loss. In fact, by 1957 it was said that hCG was the most commonly prescribed medication for weight loss. More recent and comprehensive investigations, however, refute that there is any anorexic or metabolic advantage to the use of hCG, and the drug has been summarily abandoned for this purpose

How it is supplied:

Human Chorionic Gonadotropin is widely available in various human and veterinary drug markets. Composition and dosage may vary by country and manufacturer, but typically contain 1,000, 1,500, 2,500, 5,000, or 10,000 international units (lU) per dose. All forms are supplied as a lyophilized powder, requiring reconstitution with sterile diluent (water) before use.

How it is used:

Human Chorionic Gonadotropin is generally given by intramuscular (1M) injection. The subcutaneous route is also used, and has been deemed to be roughly equivalent therapeutically to IM injections. Peak concentrations of chorionic gonadotropin occur approximately 6 hours after intramuscular injection, and 16 to 20 hours after subcutaneous injection.

When used to treat hypogonadotrophic hypogonadism, current FDA-approved protocols recommend either a short 6-week program, or a long-term program lasting up to 1 year, depending on the individual needs of the patient. Prescribing guidelines for short-term use recommend that 500 to 1,000 units to be given 3 times a week for 3 weeks, followed by the same dose twice a week for 3 weeks. The long-term recommendations call for 4,000 units to be administered 3 times weekly for 6 to 9 months, after which point the dosage is reduced to 2,000 USP units 3 times weekly for an additional 3 months. Bodybuilders and athletes use hCG either on cycle, in an effort to maintain testicular integrity during steroid administration, or after a cycle, to help restore hormonal homeostasis more quickly. Both types of use are deemed effective when properly applied.

Post-Cycle:
Human Chorionic gonadotropin is often used with other medications as part of an in-depth Post Cycle Therapy (PCT) program focused on restoring endogenous testosterone production more rapidly at the end of a steroid cycle. Restoring endogenous testosterone production is a special concern at the conclusion of each cycle, a time when subnormal androgen levels (due to steroid induced suppression) could be very costly to the physique. The main concern is the action of cortisol, which in many ways is balanced out by the effect of androgens. Cortisol sends the opposite message to the muscles than testosterone, or to breakdown protein in the cell. Left unchecked by a low level of testosterone, cortisol can quickly strip much of your new muscle mass away. Protocols for the post-cycle use of hCG generally call for the administration of 1500-4000 Units every 4th or 5th
day, taken for no longer than 2 or 3 weeks. If used for too long, or at too high a dose, the drug may actually function to desensitize the Leydig's cells to luteinizing hormone (LH), further hindering a return to homeostasis.

On-Cycle:
Bodybuilders and athletes may also administer Human Chorionic Gonadotropin throughout a steroid cycle, in an effort to avoid testicular atrophy and the resulting reduced ability to respond to LH stimulus. In effect, this practice is used to avoid the problem of testicular atrophy, instead of trying to correct it later on when the cycle is over. It is important to remember that the dosage needs to be carefully monitored with this type of use, as high levels of hCG may cause increased testicular aromatase expression (raising estrogen levels),920 and also desensitize the testes to LH. As such, the drug may actually induce primary hypogonadism when misused, greatly prolonging, not improving, the recovery window. Current protocols for the use of hCG in this manner involve administering 250lU subcutaneously twice per week (every 3rd or 4th day) throughout the length of the steroid cycle. Higher doses may be necessary for some individuals, but at no point should exceed 500lU per injection.

For Women
When used to induce ovulation and pregnancy in anovulatory infertile woman, a dose of 5,000 to 10,000 units is administered one day following the last dose of menotropins. The timing is specific so that the hormone is given precisely at the right moment in the ovulation cycle.

Human Chorionic Gonadotropin is not used by women for physique-or performance-enhancing purposes.

Side Effects:

Excessive use of hCG (beyond the amounts described above), may lead to gynaecomastia and may hinder the return to normal testicular function in males.
Other side-effects may include; headaches, restlessness, fatigue and mood changes (ie: depression). As with all drugs, you may notice side-effects that are not listed here. If you feel unwell whilst using this drug, discontinue its use.(MC)

OTHER IPEDS: Anti-oestrogenic

Drug Description:

Tamoxifen citrate is a non-steroidal anti-estrogenic drug, used widely in clinical medicine. It is specifically a Selective Estrogen-Receptor Modulator (SERM) of the triphenylethylene family, and possesses both oestrogenagonist and antagonist properties. As such, it may act as an oestrogen in some tissues while blocking the action of oestrogen in others. In breast tissue tamoxifen citrate is a strong anti-oestrogen, and as a result it is commonly used in the treatment of hormone-responsive breast cancer in women. In some cases it is even utilized as a preventative measure, taken by women with an extremely high familial tendency for breast cancer. In male bodybuilders and athletes, tamoxifen citrate is commonly used (off-label) to counter the side effects caused by elevated oestrogens subsequent to the use of certain anabolic/androgenic steroids.

Therapeutic use:

The primary use for tamoxifen citrate is as a breast cancer treatment. It blocks the action of oestrogen that may make certain types of breast cancer worse. (MC)

Tamoxifen citrate is indicated for 1) the treatment of metastatic breast cancer in women and men; 2) adjuvant treatment of node-negative breast cancer following breast surgery and radiation; 3) adjuvant treatment of node-positive breast cancer in postmenopausal women following breast surgery and radiation; 4) reduction in incidence of contralateral breast cancer (in the other breast) in the adjuvant setting; 5) reduction in incidence of invasive breast cancer in women with DCIS (Ductal Carcinoma in Situ) following breast surgery and radiation; and 6) reduction in incidence of breast cancer in women at high risk for breast cancer. In women and men with metastatic breast cancer, a dose of 10-20 mg is administered twice a day (morning and evening). When used by men (off-label) to mitigate the oestrogenic effects of anabolic/androgenic steroid use, a daily dosage of 1030 mg (1-3 tablets) is usually administered while any offending steroids are taken, or as part of a comprehensive post-cycle hormone recovery program.

How it is supplied:

Tamoxifen citrate is most commonly supplied in tablets of 10 mg or20 mg.

How it is used:

When used as part of a steroid cycle; it is most commonly used during the cycle in small doses (typically 10-20mg per day) to try and prevent gynaecomastia (how effective this is may depend on the steroid dose being used). It is also used in post cycle therapy (PCT) to help restore endogenous testosterone production. For this purpose, the most common protocol is 3-4 weeks of daily use, starting at 40mg per day in the first week and then reducing the dose each week down to 20 mg per day.

It should be noted there is very little clinical evidence to support this protocol.

Women do not typically use this drug for physique or performance enhancing purposes (MC)

Side Effects:

There is little reliable information available on the side-effects of tamoxifen in men. However, there is some limited evidence to show long term use can lead to weight gain and sexual dysfunction.

Drug Description:

Clomiphene citrate is an anti-oestrogenic drug that is prescribed to women to treat anovulatory infertility (inability to ovulate). In clinical medicine it is specifically referred to as a nonsteroidal ovulatory stimulant. The drug works by interacting with oestrogen receptors, often in an antagonistic manner, in various tissues of the body including the hypothalamus, pituitary, ovary, endometrium, vagina, and cervix. One main focus is that the drug will oppose the negative feedback of oestrogens on the hypothalamic-pituitary-ovarian axis, enhancing the release of gonadotropins (LH and FSH). This surge in gonadotropins may cause egg release (follicular rupture), ideally leading to conception. Clomiphene citrate is chemically a synthetic oestrogen with both agonist/antagonist properties, and in this regard is very similar in structure and action to Nolvadex®.

(Nolvadex is a trade name for tamoxifen citrate - MC)

Therapeutic use:

Clomiphene citrate is FDA approved for the treatment of women with ovulatory dysfunction preventing pregnancy.
This drug is commonly used as a fertility treatment for females in the UK, but not typically for males.

How it is supplied:

Clomiphene citrate is most commonly supplied in tablets of 50 mg.

How it is used:

When used by men (off-label) to mitigate the oestrogenic side effects of anabolic/androgenic steroid use, a daily dosage of 50-1 00 mg (1-2 tablets) is usually administered while any offending steroids are taken. Note, however, that tamoxifen is usually given preference over clomiphene citrate for this purpose. More commonly, clomiphene citrate is used by men at a dosage of 50-100 mg per day for 30 days at the conclusion of a steroid cycle, in an effort to bring natural testosterone production back to normal levels. Here, it is usually deemed most appropriate to use as part of a multi-component post-cycle recovery program.

Female athletes occasionally use clomiphene citrate for the reduction of estrogenicity near the time of a bodybuilding contest. In some instances this may aid in increasing fat loss and muscularity, particularly in female trouble areas such as the hips and thighs. The drug, however, often produces very troubling side effects in pre-menopausal women, and is likewise not in very high demand among this group.

Side Effects:

Some patients using clomiphene citrate notice blurring or other visual disturbances such as spots or flashes. These symptoms occur more frequently at higher doses or longer durations of therapy, and often disappear within a few days or weeks of use. Prolonged visual disturbances have been reported after the discontinuation of clomiphene citrate therapy, however, and in some cases may be irreversible. Those taking clomiphene citrate should be warned that these symptoms might make activities like driving a car or operating heavy machinery more hazardous than usual. While the exact cause of these visual symptoms is not yet understood, it is advisable to discontinue treatment and have a thorough medical/opthalmological examination should they occur.
It has also been widely reported by steroid users that use of clomiphene has led to mood changes such as depression. This can sometimes be quite severe, such that some users have permanently discontinued use of this drug.

Drug Description:

Exemestane is a steroidal suicide aromatase inhibitor. It is very similar in structure and action to formestane, although it is significantly more potent in comparison. As a class of drugs, aromatase inhibitors offer an anti-estrogenic effect by blocking the enzyme responsible for synthesising oestrogens. Exemestane is approved by the FDA for the treatment of breast cancer in women, specifically in postmenopausal patients whose cancer has progressed following therapy with tamoxifen. Male bodybuilders and athletes often use the drug for non-approved purposes, namely to counter the oestrogenic side effects associated with the use of aromatisable anabolic/androgenic steroids. This may include gynaecomastia, fat build up, and water retention. In some instances aromatase inhibitors may also assist this group with the loss of body fat and increases in muscular definition. Exemestane is one of the most potent aromatase inhibitors presently available.

Therapeutic use:

Exemestane is FDA approved for adjunctive treatment of postmenopausal women with oestrogen-receptor positive early breast cancer with disease progression following tamoxifen. Therapy is initiated 2-3 years after tamoxifen has failed to elicit a desirable response, at which point tamoxifen is discontinued. Treatment with exemestane is continued for 2-3 additional years, and is completed after 5 years of cumulative adjunctive drug therapy (tamoxifen and exemestane treatment combined). The dosage prescribed in all instances is one 25 mg tablet per day, taken after a meal.

How it is supplied:

Exemestane is most commonly supplied in tablets of 25 mg.

How it is used:

When used to mitigate the oestrogenic side effects of anabolic/androgenic steroid use or increase muscle definition, male athletes and bodybuilders will commonly take 12.5 mg to 25 mg of exemestane per day. In some instances a half of a tablet (12.5 mg) taken every other day is sufficient to prevent the onset of oestrogenic side effects.

Side Effects:

Common side effects associated with the use of an aromatase inhibitor include hot flashes, joint pain, weakness, fatigue, mood changes, depression, high blood pressure, swelling of the arms/legs, and headache. Aromatase inhibitors may also decrease bone mineral density, which may lead to osteoporosis and an increase in fractures in susceptible patients. Some individuals may also respond to the medication with gastrointestinal side effects including nausea and vomiting. Aromatase inhibitors can harm the development of an unborn foetus, and should never be taken or handled during pregnancy. When taken by men (as an off-label use) to reduce oestrogenicity during prolonged periods of steroid treatment, aromatase inhibitors may increase cardiovascular disease (CVD) risk by retarding some beneficial properties of oestrogen on cholesterol values. Studies have demonstrated that when an aromatisable steroid such as testosterone enanthate is taken in conjunction with an aromatase inhibitor, suppression of HDL (good) cholesterol levels become significantly more pronounced. Since the oestrogen receptor agonist/antagonist Nolvadex® generally does not display the same anti-estrogenic (negative) effect on cholesterol values, it is usually favoured over aromatase inhibitors for oestrogen maintenance by male bodybuilders and athletes concerned with cardiovascular health.

Therapeutic use:

There is no current medical use for this drug.

How it is supplied:

Ephedrine can be found in many over the counter fat loss products, usually in small quantities. It is also available in a range of preparations on its own. Either as a powder or in capsules or tablets. Typically the tablets are between 25-50mg.

Therapeutic use:

Whilst this drug is approved for use in the US as an obesity management drug, it is rarely used. In the UK it has been discontinued as highlighted here:January 2010 discontinued in the UK: This medicine has been reviewed by the European Medicines Agency. The review suggests that there is an increased risk of non-fatal heart attacks and strokes with this medicine and this outweighs the benefits of weight loss achieved with this medicine. People who are currently taking Reductil are advised to make a routine appointment with their doctor to discuss alternative measures to lose weight. There are no health implications if people wish to stop taking this medicine before seeing their doctor.

Drug Description:

DNP is one of the most controversial drugs in use by bodybuilders. This agent is not sold for human use anywhere in the world at this time, but is readily available as an industrial chemical. Among other things, it is used as an intermediary for the production of certain dyes, for photographic development, as a fungicide, in wood pressure-treatment to prevent rotting, and as an insecticide. It is technically classified as a poison. Although quite incongruous with this list of strong industrial/chemical uses, this chemical was sold during the era of patent medicine as a diet drug for humans. It is this property of dinitrophenol that remains of interest to some bodybuilders today.